title: Special needs children with speech and hearing difficulties: prevalence and unmet needs.
abstract: OBJECTIVE
  The purpose of this study was to establish prevalences and sociodemographic characteristics associated with parent-reported speech and hearing difficulties among children with special health care needs (CSHCN); determine unmet needs for therapy, hearing aids, and communication devices; and examine the association between unmet needs and resources such as health insurance, early intervention/special education, and a medical home.
  
  
  METHODS
  Data were analyzed for 300,910 children without special health care needs and 40,723 CSHCN from the 2005-2006 National Survey of Children with Special Health Care Needs. Prevalence, sociodemographic characteristics, and unmet needs for 7132 CSHCN with speech difficulties and 1982 CSHCN with hearing difficulties were assessed. Logistic regression was used to determine the associations between unmet needs for therapy or hearing/communication devices and resources for addressing needs for therapy, hearing, and communication aids.
  
  
  RESULTS
  The parent-reported prevalence of speech difficulty among CSHCN in the general population was 2.9% and approximately 20% among all CSHCN, in contrast to the lower prevalence of hearing difficulty (0.7% and 5%, respectively). Relative unmet need was greatest for communication devices and least for hearing aids. The strongest association with reducing unmet needs was having a medical home, and the most significant aspect of medical home was having effective care coordination.
  
  
  CONCLUSIONS
  Having a medical home is significantly associated with fewer unmet needs for therapy and hearing/communication devices among CSHCN with speech and hearing difficulties. Care coordination may constitute an important factor that allows the primary care provider to link with services that CSHCN with communication problems require.
authors.affiliation: US Department of Health and Human Services, Health Resources and Services Administration, Maternal and Child Health Bureau, Rockville, Maryland 20857, USA. mkenney@hrsa.gov
authors.forename: Mary Kay
authors.initials: MK
authors.lastname: Kenney
authors.forename: Michael D
authors.initials: MD
authors.lastname: Kogan
mesh_terms: D002648:Child; D002675:Child, Preschool; D019988:Children with Disabilities; D005260:Female; D006301:Health Services Needs and Demand; D006311:Hearing Disorders / Q000453:epidemiology*; D006801:Humans; D007223:Infant; D016015:Logistic Models; D008297:Male; D015995:Prevalence; D013064:Speech Disorders / Q000453:epidemiology*; D014481:United States / Q000453:epidemiology